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Date run 3/1,7/2017 9:52:03AR SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Report#5021 <br /> Run by Pagel <br /> Facility Information as of 3/17/2017 <br /> Record Selection Chains: Facility ID FA0021387 <br /> Make changes/corrections in RED ink. <br /> INFORMATION CHANGE(date) <br /> OWNERSHIP CHANGE(date) <br /> OWNER FILE INFORMATION Number of facilities for this owner: 50 SSN(Fed Tax ID : <br /> Owner ID OW0007658 Case Number: H05085 New Owner ID <br /> Owner Name Pacific Gas and Electric Company <br /> Owner DBA <br /> Owner Address 29 FOURTH ST <br /> MARYSVILLE, CA 95901 <br /> Home Phone Not Specified <br /> Work/Business Phone 415-973-7000 <br /> Mailing Address c/o Environmental Services, 3401 Crow CanyC <br /> San Ramon, CA 94583 <br /> Care of RODNEYHEARNE <br /> FACILITY FILE INFORMATION <br /> Facility ID/CERS ID FA0021387 <br /> Facility Name PG&E(MCMULLIN DEHYDRATOR) <br /> Location 26250 S AIRPORT WAY <br /> MANTECA, CA 95337 <br /> Phone 415-973-7000 <br /> Mailing Address 29 4TH ST <br /> MARYSVILLE, CA 95901 <br /> Care of RODNEYHEARNE <br /> Location Code 99- UNINCORPORATED P Alt Phone <br /> BOS District 005 - ELLIOTT, BOB Fax <br /> APN 25703010 EMail: <br /> EMERGENCY NOTIFICATION CONTACT INFORMATION <br /> Contact Name <br /> Title <br /> Day Phone <br /> Night Phone <br /> ACCOUNTS RECEIVABLE FILE INFORMATION <br /> Account ID AR0038752 New Account ID: <br /> Mail Invoices to Facility Mail Invoices to: Owner / Facility / Account <br /> Account Name PG&E (MCMULLIN DEHYDRATOR) (Circle One) <br /> Account Balance as of 3/17/2017: 00 L` / rte S <br /> Cilie one) <br /> Transfer to Active <br /> ProgremlElement and Description Record ID Employee ID and Name Status New Omer' Delete <br /> 1921 -HMBP-Regular-Primary Location PRO537260 EE0000009-NICHOLAS LOEHRER Active Y N A CJ D <br /> BILLING and COMPLIANCE ACKNOWLEDGEMENT'. I,the undersigned owner,operator or agent of same,acknowledge that all site,andor project specific,PHSIEHD hourly charges associated with this facility <br /> or adiviy will be billed to the parry identified as the OWNER on this forth. 1 also cis that all operations will be performed in accordance with all applicable Ordinance Codes andor Standards and State andor <br /> Federal Laws. <br /> APPLICANT'S SIGNATURE: Date / I <br /> Program Records to be TRANSFERED: '$25.00= Amount Paid Date <br /> Water System to be TRANSFERED: Amount Paid Date / / <br /> Payment Type Check Number Received b <br /> EHD Staff: Date Account out: Date / L' /� <br /> COMMENTS: <br /> Invoice#: <br />